Comparative Risk Assessment of Major Infectious Pathogens Based on Antimicrobial Resistance, Transmissibility, and Mortality

 Title: Comparative Risk Assessment of Major Infectious Pathogens Based on Antimicrobial Resistance, Transmissibility, and Mortality

Abstract

This paper presents a quantitative framework to rank over 50 major infectious pathogens using a triadic scoring system encompassing antimicrobial/antiviral resistance, transmissibility, and mortality. Based on compiled epidemiological data and expert-informed estimations, each pathogen is assigned a score from 1 to 10 across three dimensions, yielding a total threat index score. This ranking aims to guide public health prioritization and resource allocation.

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1. Introduction

Infectious diseases continue to pose significant threats to global health, particularly with the emergence of multidrug-resistant organisms (MDROs) and high-mortality viral pathogens. A unified comparative risk index allows for more coherent threat analysis and strategic public health planning. This paper introduces a tri-score system for assessing 52 pathogens across resistance, transmissibility, and lethality.

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2. Methodology

Each pathogen is evaluated using three independent variables:

• Antimicrobial/Antiviral Resistance Score (R): Resistance to treatment, scored 1 (susceptible) to 10 (highly resistant).

• Transmissibility Score (T): Propensity to spread among individuals, 1 (low) to 10 (high).

• Mortality Score (M): Case fatality rate, severity of outcomes, 1 (mild) to 10 (high fatality).

Final threat index is computed as:

$$\text{Total Risk Score} = R + T + M$$

Scoring was derived from CDC, WHO data, and peer-reviewed literature, with adjustment for emergent data in 2024–2025.

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3. Results: Pathogen Ranking

Top-ranked pathogens included:

Rank	Pathogen	R	T	M	Total
1	VRE	10	8	7	25
2	MDRPA	9	7	7	23
3	CRE	9	6	7	22
4	CRAB	10	6	6	22
5	XDR-TB	7	6	9	22
...	...	...	...	...	...

A total of 52 pathogens were ranked. Results showed MDROs dominate top risk tiers due to treatment challenges and moderate-to-high mortality.

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4. Discussion

This ranking highlights the rising global threat of antimicrobial resistance. While viral pathogens such as Ebola and Marburg exhibit high lethality, their lower transmissibility and absence of resistance confer a lower composite score than certain bacteria. Conversely, measles and influenza demonstrate high transmissibility but lower lethality, underlining the multifactorial nature of risk.

Moreover, chronic infections such as HIV and hepatitis B/C score moderately across all dimensions due to long-term impacts and moderate transmissibility, emphasizing the need for persistent public health investment.

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5. Limitations

The scoring system relies on estimated ranges and expert synthesis, not purely empirical calculation. Further, regional variance in healthcare access, vaccination coverage, and environmental factors may alter pathogen impact. Future work may include weighted modeling, dynamic transmission simulations, or regionalized scoring.

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6. Conclusion

This study provides a comparative model to assess the risk posed by infectious agents across resistance, spread, and severity. The highest-risk pathogens are predominantly bacterial MDROs, although viruses with pandemic potential remain critical targets. Policymakers can use this framework for priority setting in infection control, surveillance, and R&D.

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References

1. World Health Organization (WHO). Global priority pathogen list 2024.

2. Centers for Disease Control and Prevention (CDC). Antibiotic Resistance Threats in the United States, 2023.

3. European Centre for Disease Prevention and Control (ECDC). Annual Epidemiological Report 2024.

4. Peer-reviewed journals (e.g., Lancet Infectious Diseases, Clinical Infectious Diseases) for specific pathogen data.

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